When a parent or spouse in Florida needs nursing-home care, Florida Medicaid can help pay for it. Under the state's July 2026 standards, a single applicant's countable assets must be at or under $2,000 ($5,000 if income is within the MEDS-AD limit), and monthly income at or under $2,982 unless the income over that limit is deposited each month into a qualified income trust (described below). Florida also has separate rules that protect a spouse living at home.
This page is for families facing a nursing-home admission in Florida. A mother has had a fall and will not be going home from rehab. A husband's memory care has become more than one person can provide. The monthly bill for care is arriving faster than savings can cover it. The family is trying to work out three things: whether Medicaid will pay, what has to be spent first, and what the spouse still living in the house gets to keep. This page sets out what Florida's own official sources say about those questions, and it notes where those sources are silent.
A note on gaps in the sources. How the need for care is assessed is governed by Florida's full and current rules rather than by the official pages relied on here, and how DCF's trust and annuity rules, described below, apply to a particular document depends on its terms. Where that is the case, this page says so briefly instead of guessing.
How Florida Medicaid Works for Long-Term Care
Two state bodies divide the work. According to the Florida Department of Children and Families Medicaid page, Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or by the Social Security Administration (for SSI recipients). The Agency for Health Care Administration (AHCA) administers the Medicaid program itself.
Federal law sets the outer framework. The Centers for Medicare & Medicaid Services eligibility policy page describes Medicaid as "a joint federal and state program." It also explains that states may choose to cover optional groups, "such as individuals receiving home and community-based services."
For long-term care, Florida's DCF policy manual on assets names the programs that Florida's transfer rules apply to:
- the Institutional Care Program (ICP), which covers nursing-home care
- institutionalized MEDS-AD
- institutionalized Hospice
- Home and Community Based Services (HCBS) programs
- the Program for All-Inclusive Care for the Elderly (PACE)
Medicaid is not Medicare. This page covers Medicaid for long-term care only. It does not cover Medicare, private long-term-care insurance or veterans' benefits.
Eligibility has two sides:
- Financial eligibility: the asset and income limits explained below.
- Need for care: whether the person needs the level of care the program provides. The official pages relied on here do not set out how Florida assesses this.
Florida Medicaid Eligibility: Assets, Income, and the Countable-Asset Limit
DCF publishes its current figures in Appendix A-9 of its policy manual, dated July 2026. For the ICP, HCBS and Hospice coverage group, the limits for an individual are:
- Income limit: $2,982 a month. The chart describes this as 300% of the SSI federal benefit rate of $994.
- Asset limit: $2,000, or $5,000 if the individual's income is within the MEDS-AD limit, which the chart lists as $1,171 a month for an individual and marks as changing each April 1. For an eligible couple, DCF's asset manual sets $3,000, or $6,000 within the MEDS-AD limit.
The chart marks the ICP, HCBS and Hospice standards as changing each January 1 "in accordance with federal law."
What counts. A countable asset is any resource Medicaid adds up toward that limit. An exempt asset is one Medicaid does not count. The DCF manual lists exclusions, including these two:
- Life estates. "Any life estate interest held by an individual, the individual's spouse, a child or specified relative is excluded as an asset to the individual." A life estate is a right to use a property for life. There is one condition: a life estate received through a transfer within 60 months of an application for institutional care or HCBS must be evaluated under the transfer rules. Because of that condition, a life estate matters both to the asset count and to the look-back review described below. An enhanced life estate, also known as a lady bird deed or life estate with powers, is treated differently: the manual counts it the same as other real property the individual owns, though it may be excluded if it qualifies as the individual's homestead.
- Certain Indian land. Land held by an enrolled tribal member is excluded if it cannot be sold or transferred without permission from other individuals, the tribe or a federal agency.
Families often ask about the home, a car, personal belongings and prepaid burial arrangements. The home's equity limit is covered below. For the other items, the DCF manual provides:
- A car. "One automobile, regardless of value or use, is excluded as an asset." Any other automobile is counted at its equity value unless another exclusion applies.
- Personal belongings. Household goods and personal effects, such as furniture, appliances, clothing and personal jewelry, are excluded regardless of their dollar value. Items acquired or held for their value or as an investment are not treated as household goods or personal effects and may be counted.
- Burial funds. An individual and the individual's spouse may set aside up to $2,500 each for burial expenses. The funds are excluded as long as the individual states they are set aside for burial, and they generally must be kept separate from funds that are not.
- Prepaid burial contracts. The contract funds are not counted if the contract is irrevocable, cannot be liquidated without significant hardship to the individual, or the seller refuses to revoke or liquidate it. Otherwise, the amount the individual would receive by revoking or liquidating the contract, minus any penalties, is counted.
Income and the income cap. Many families hear about a Qualified Income Trust, often called a Miller Trust. This is a trust arrangement that receives income above an income cap so that the applicant's countable income falls within the limit. DCF's income chapter says that, to qualify, an individual's gross income cannot exceed 300 percent of the SSI federal benefit rate, and that someone whose income is above the ICP income limit may become eligible for institutional care or HCBS by setting up and funding a qualified income trust. The chapter lists what such a trust must be: established on or after October 1, 1993 for the individual's benefit, irrevocable, made up only of the individual's income, and providing that the state receives the balance at the individual's death up to the total medical assistance paid.
Once a person is in a nursing home under ICP, HCBS, Hospice or PACE, Appendix A-9 lists a monthly personal needs allowance of $160. This is the amount the resident keeps for personal needs.
The Five-Year Look-Back Period in Florida
The DCF asset manual says that at application and at eligibility reviews, "individuals must provide information regarding assets transferred prior to the application or eligibility review."
The manual also explains what counts as a transfer. A transfer occurs when an individual, their spouse, a legally authorized representative, or a joint owner of a jointly held asset does not receive fair compensation for it.
The look-back period is the window of time before an application during which those transfers are examined. The look-back length is not the same in every state. The DCF asset manual states that "the look-back period begins with the month of application, counting backwards," and that "the look-back period for non-trust transfers is 60 months." It also notes that "the time periods for asset transfers and the specific policy for transfer of assets vary by program."
A penalty period is a stretch of time during which Medicaid will not pay for long-term care because of a transfer made for less than fair value. Florida's figures on this are:
- Divisor: Appendix A-9 lists a "Transfer of Asset Divisor" of $10,645, dated 04/01/2025. The DCF asset manual's formula is: "Uncompensated value divided by the average private nursing home rate equals the number of months of ineligibility." The uncompensated value is the transferred asset's fair market value at the time of the transfer, less any loans or other encumbrances on it, minus the compensation received. For transfers on or after November 1, 2007, the uncompensated values of all such transfers are added together before dividing, the result is not rounded down, and a fraction of a month is converted to days by multiplying it by 30.
- Start date: for transfers on or after November 1, 2007, the manual begins the penalty period on the latest of the first day the person would be eligible for long-term-care Medicaid were it not for the penalty (which includes filing an application and meeting all criteria), the first day of the month of the transfer, and the first day after an existing penalty period ends.
- No cap on length: the manual states that "there is no limit on the number of months of ineligibility."
Not every transfer is penalized. Transfers between spouses are one exception: DCF's asset manual lists interspousal transfers made on or after October 1, 1989 among its "allowable" transfers, for which no period of ineligibility will be imposed, and states that "Transfer of assets between spouses does not affect eligibility." Under 42 U.S.C. § 1396p, likewise, a person is not ineligible to the extent assets were transferred to the person's spouse or to another for the sole benefit of the spouse. At application, though, the assets of both spouses are considered together, as described under spousal protections below. Separately, under 42 U.S.C. § 1396r-5, an institutionalized spouse may transfer an amount equal to the community spouse resource allowance to, or for the sole benefit of, the spouse at home "without regard to" the federal transfer-penalty provision in 42 U.S.C. § 1396p(c)(1), with the transfer made as soon as practicable after eligibility is first determined. Transfers made under a court order for the support of the community spouse are treated the same way. The DCF manual also treats as allowable the transfer of a home to the person's spouse, a child under 21, a blind or permanently disabled adult child, a sibling who has an equity interest in the home and lived there for at least one year immediately before the person became institutionalized, or an adult son or daughter who lived there for at least two years immediately before that date and provided care that delayed the institutionalization. Federal law and Florida's rules contain other exceptions. Which of them applies to a family's transfers turns on the facts.
For an adult child who has been writing checks from a parent's account for years, the answer turns on the dates, the amounts and what each payment was for.
Spousal Protections: What the Community Spouse Keeps
Federal law gives the spouse at home specific protections, and Florida applies them with its own figures. The community spouse is the husband or wife who stays at home while the other spouse receives Medicaid-covered long-term care.
Income. Under 42 U.S.C. § 1396r-5, during any month the institutionalized spouse is in the institution, generally "no income of the community spouse shall be deemed available to the institutionalized spouse."
Assets at application. The federal rules work in steps:
- At the start of the first continuous period of institutionalization, the state computes the couple's total resources and a "spousal share" equal to one-half of that total.
- At application, resources held by either spouse are considered available to the institutionalized spouse. However, they are counted only to the extent they exceed the community spouse resource allowance.
- Either spouse may ask the state to assess and document the couple's total resources. The assessment comes with a notice of the right to a fair hearing.
- After the month eligibility is established, the community spouse's resources are no longer deemed available to the institutionalized spouse.
The Community Spouse Resource Allowance (CSRA) is the share of the couple's countable assets that the community spouse may keep. Appendix A-9 lists Florida's CSRA as $162,660. It is one of the standards that change each January 1.
The Minimum Monthly Maintenance Needs Allowance (MMMNA) is the minimum monthly income allowed for the community spouse. Appendix A-9 lists it at $2,705 for July 2026. The chart notes that it changes each July 1. The federal CMCS Informational Bulletin of April 27, 2026 confirms that the MMMNA and the related housing allowance are adjusted each July 1. Appendix A-9 lists Florida's own cap on the community spouse's income allowance, shown as "CSMIA," at $4,067, one of the standards that change each January 1.
Spousal refusal. Some families ask whether the spouse at home can decline to contribute. Federal law allows an institutionalized spouse to be found eligible in limited situations, including when support rights against the community spouse have been assigned to the state, or when denial would work an undue hardship. DCF's asset manual says that if, after declaring and verifying the assets, the community spouse refuses to make them available, the institutionalized spouse may assign rights of support to the state, on an Assignment of Rights to Support form that allows the state to pursue recovery from the community spouse. Under the manual, the institutionalized, HCBS or PACE spouse will not be found ineligible based on the community spouse's assets if all four of these conditions exist: that spouse is not eligible because of the community spouse's assets and the community spouse refuses to use them for that spouse; the assignment form is signed; that spouse would be eligible if only the assets that spouse can access were counted; and that spouse has no other means to pay for long-term care services. The manual adds that the form "is not an option that an eligibility specialist suggests to an ineligible couple, but rather a solution to an existing situation."
The Family Home and Florida Medicaid Estate Recovery
During the applicant's lifetime, the Florida figure that matters most for the home is equity. Appendix A-9 lists a "Home Equity Interest Limit" of $752,000, which changes each January 1. The DCF asset manual says that home property is excluded as an asset, regardless of its value, if it is the individual's principal place of residence, and that a temporary absence, however long, does not end the exclusion if a spouse or dependent relative continues to live in the home, if selling the home would cause undue hardship to a co-owner through the loss of a primary residence, or if the individual states an intent to return home. For nursing-home and other long-term care, it says an individual whose home equity is above the Appendix A-9 standard is ineligible unless the individual's spouse, child under age 21, or blind or disabled child lives in the home, or the home equity provision is waived because denial of long-term care services would result in demonstrated hardship to the individual.
Estate recovery is the process by which a state seeks repayment from a deceased recipient's estate for Medicaid it paid.
The federal rule. Under 42 U.S.C. § 1396p(b), for a recipient who was 55 or older when the help was received, a state must seek recovery from the estate for:
- nursing facility services
- home and community-based services
- related hospital and prescription drug services
A state may also choose to recover for other services. Recovery may be made only after the death of the surviving spouse, if any. It also cannot be made while there is a surviving child who is under 21, or who is blind or disabled as the statute describes.
Florida's rules. Florida's Medicaid Estate Recovery Act in the 2026 Florida Statutes provides that:
- How recovery happens: the agency files a statement of claim against the estate of a deceased recipient in the probate proceeding.
- What creates the debt: accepting Medicaid creates a debt for the amounts paid "after the recipient reached 55 years of age." Payments made before age 55 do not create a debt.
- When the debt is not enforced: the debt "shall not be enforced" if the recipient is survived by a spouse, a child under 21, or a child who is blind or permanently and totally disabled under federal Medicaid (Title XIX) eligibility requirements.
- Exempt property: "No debt under this section shall be enforced against any property that is determined to be exempt from the claims of creditors under the constitution or laws of this state." Whether a particular property, including a Florida home, is exempt turns on Florida law and the facts.
- Sale of property: where there are no liquid assets to satisfy the claim, nonexempt personal property or real property "which is not protected homestead" is sold to satisfy it if the costs of sale will not exceed the proceeds, and real property is never transferred to the agency.
- Hardship waivers: the agency shall not recover if doing so would cause undue hardship for the qualified heirs. The personal representative or any heir may request a waiver. However, a hardship does not exist "solely because recovery will prevent any heirs from receiving an anticipated inheritance."
- Upper limit: recovery can never exceed the total Medicaid assistance provided.
No plan can be said to avoid estate recovery. What happens depends on the estate, the property and the family members who survive.